Using Narrative Therapy for Couples to Address Discontinuity Narratives in Couples Living with Brain Injury

ABSTRACT Brain injuries can put marriages and partnerships under considerable strain. One contributor to this is narratives about the relationship focused on discontinuity, rupture and loss, in which life after the injury is compared unfavourably to life before. Similar narratives about rupture and loss also affect the self‐identity and well‐being of both partners. Aims were to develop structured guidance about applying narrative therapy with couples following brain injury and to explore its usefulness for this purpose. The therapy focused on helping couples identify continuities in their life (including values and strengths) and develop richer narratives about their life together. The general principles of narrative therapy with couples are outlined, and a session‐by‐session plan is described that translates these principles into specific practice. Individual and couple trees of life were also used as part of the therapy. Three couples received the therapy. To evaluate its usefulness, couples were asked to provide feedback about their experience of it and to complete questionnaires about their relationship and individual well‐being before and after therapy. A description is given of the therapy's application for each of the three couples and their response to it. All three couples described how they had benefited from the therapy, and all showed some statistically reliable improvements on the questionnaires. Narrative family therapy, with its emphasis on empowerment and the value of richer narratives, may be particularly useful in a brain injury context where couples often feel helpless and their experience is dominated by narratives of rupture and loss. Structured guidance for its application also has the potential to enable its delivery by clinicians working in rehabilitation settings who do not have highly specialist training in relationship therapies. Further refinements of the guidance are needed, and the approach needs to be evaluated in more diverse contexts.